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Detectability of chemically induced periapical lesions by limited cone beam computed tomography, intra-oral digital and conventional film radiography

¹Department of Oral Diagnosis & Radiology, School of Dentistry, Ege University, Izmir, Turkey; ²Department of Oral and Maxillofacial Radiology, Institute of Odontology, The Sahlgrenska Academy, Göteborg University, Göteborg, Sweden; ³Department of Endodontics, School of Dentistry, Ege University, Izmir, Turkey

*Correspondence to: Elif Sogur, Ege Universitesi, Dishekimligi Fakultesi, Oral Diagnoz & Rad AD, Bornova, 35100, Izmir, Turkey; E-mail: esogur{at}yahoo.com

Received 15 April 2008; revised 6 June 2008; accepted 31 July 2008

Objective: Our aim was to compare the Accu-I-Tomo (3DX), the Digora® Optime image plate system and F-speed film in detecting chemically created apical lesions.

Methods: Lesions were created by applying perchloric acid apical to extracted teeth in jaw specimens for 1, 1.5 or 2 h. After being repositioned, teeth were radiographed with Accu-I-Tomo limited cone beam CT (LCBCT), Digora® Optime storage phosphor plates (SPP) and F-speed films. Six observers scored the presence of lesions using a five-grade scale. The accuracy of each observer and modality was assessed through receiver operating characteristic (ROC) analysis and A_z values were compared using two-way ANOVA. Pairwise comparisons of imaging systems were carried out using the Mann–Whitney U-test. Differences in A_z values were compared using Friedman and Dunn's tests. Kappa () was used to measure interobserver agreement.

Results: The A_z values were larger for LCBCT than for SPP and film for all acid durations. For 1 h of acid duration a significant difference was found between LCBCT and film (P = 0.02) and between LCBCT and SPP (P = 0.0043), For 1.5 h a significant difference (P = 0.006) was found between LCBCT and SPP only. For 2 h acid duration, there was no significant difference between LCBCT and film or SPP (P>0.05). Between SPP and film no significant difference was found for any acid duration (P>0.05). ranged between fair and moderate for LCBCT and between slight and fair for SPP and film.

Conclusion: LCBCT images provided better than or similar detectability as film and SPP images of chemically created periapical lesions.

Keywords: computed tomography; cone beam; periapical lesion; radiology